How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $173.78 Median $407.38 Typical High $512.86 | Professional | None | $173.78 | $407.38 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $181.97 | Professional | None | $158.49 | $177.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,818.38 | Facility | None | $446.68 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $812.83 | Professional | None | $169.82 | $416.87 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Professional | None | $398.11 | $537.03 | $891.25 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $158.49 Median $426.58 Typical High $1,071.52 | Professional | None | $158.49 | $426.58 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | None | $436.52 | $436.52 | $724.44 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $87.10 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $34.67 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $131.83 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $26.30 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $17.38 | $40.74 | $51.29 |
Where Maryland sits
The same service costs 3.6 times more in Alaska than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 36th of 51
$457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.